Zielparameter der Volumensubstitution nach Verbrennungstrauma View Full Text


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Article Info

DATE

2004-10

AUTHORS

M. V. Küntscher, B. Hartmann

ABSTRACT

A successful surgical and intensive care treatment of severely burned patients requires adequate pre-hospital management and fluid resuscitation adjusted to the individual needs of the patient. Burn shock fluid resuscitation is currently predominantly performed utilizing crystalloid solutions. Colloid solutions should not be given in the first 24 hours after burn injury whenever possible. Colloids can be given after 8 hours if intravascular volume cannot be maintained despite massive administration of crystalloids. Large total body surface area (TBSA) burns and inhalation injuries frequently require this earlier use of colloids. The rate of administration of resuscitation fluids should maintain urine outputs between 0.5 and 1 ml/kg/h and mean arterial pressures of >70 mmHg. An extended hemodynamic monitoring can provide valuable additional information, if burn resuscitation is not proceeding as planned, or volume therapy guided by these typical vital signs is not attaining the desired effect. We recommend this in patients with burns >30% TBSA. Inhalation injuries, preexisting cardiopulmonary diseases or burns >50% TBSA definitely require an extended hemodynamic monitoring during burn shock resuscitation. The Swan-Ganz catheter or less invasive transcardiopulmonary indicator dilution methods can be utilized to assess hemodynamic data. Hyperdynamic endpoints (cardiac index: 4.5 to 5.5 l/min/m2; oxygen delivery index: >600 ml/ min/m2) and a low systemic vascular resistance (SVRI: 900 to 1100 dynes ·s/m2/cm5) should be reached within the first few hours after burn injury. More... »

PAGES

499-504

References to SciGraph publications

  • 1992-01. Burn shock resuscitation in WORLD JOURNAL OF SURGERY
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00390-004-0509-1

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    http://dx.doi.org/10.1007/s00390-004-0509-1

    DIMENSIONS

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